Fecal occult blood screening may help reduce colorectal cancer mortality

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NEW YORK (Reuters Health), Apr 6 - Pilot studies indicate that a population-based approach to guaiac fecal occult blood testing (FOBT) appears likely to reduce colorectal cancer mortality, Scottish researchers report in the April issue of Gut.

"This study," lead investigator Dr. Robert J. C. Steele told Reuters Health, "clearly demonstrates that a national screening program for bowel cancer using fecal occult blood testing has the potential to reduce death rates from this disease by between 15% and 20%."

"As a result of this study," he added, "the Scottish Government Health Department has committed to rolling out a national screening program, which should be complete by the end of 2009. A similar activity is taking place in the rest of the United Kingdom."

Dr. Steele of Ninewells Hospital & Medical School, Dundee, and colleagues conducted the screenings in the Grampian, Tayside and Fife areas of the country. More than 300,000 subjects participated. Overall, the uptake -- the proportion of those invited who actually attended -- was about 55%.

In the first round, the positivity rate was 2.07% and the cancer detection rate was 2.1 per 1,000. For the second round, corresponding values were 1.9% and 1.2 per 1,000. In the third and final round, they were 1.16% and 0.7 per 1000.

Over the three rounds, positive predictive values for cancer were 12%, 7%, and 7.5%, and for adenoma, they were 36.5%, 30.3%, and 29.1%. The corresponding percentages detected at Duke's stage A were 49.2, 40.1, and 36.3.

Despite the apparent promise of the approach, concluded Dr. Steele, "it has to be emphasized that success of these programs is crucially dependent on uptake, and future efforts must focus on engaging the British population in this activity."

Gut 2009;58:530-535.

Last Updated: 2009-04-03 16:50:17 -0400 (Reuters Health)

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